Differences in behavioral and emotional problems among children aged 1-4 years from two independent cohorts in Montevideo, Uruguay: the 2013 and 2018 ENDIS studies

Braz J Psychiatry. 2026 Jul 20. doi: 10.47626/1516-4446-2026-4981. Online ahead of print.

ABSTRACT

OBJECTIVE: To examine differences in behavioral and emotional problems among children aged 1-4 years using baseline data from two independent Uruguayan cohort studies (2013 and 2018), and to investigate whether differences were explained by socioeconomic, maternal, and child characteristics.

METHODS: Data from two independent Montevideo cohorts (2013: n=790; 2018: n=743) were analyzed. Behavioral and emotional problems were assessed through maternal report using the Child Behavior Checklist for Ages 1½-5 (CBCL 1½-5). Between-cohort differences were examined using ANCOVA with sequential adjustment for socioeconomic, maternal, and child characteristics.

RESULTS: The 2018 cohort showed higher CBCL scores for total problems (mean difference=1.87, Cohen’s d=0.10, 95%CI:0.00-0.20, p=0.049) and internalizing problems (mean difference=1.01, d=0.17, 95%CI:0.07-0.27, p=0.001). Externalizing scores showed a non-significant trend (mean difference=0.57, d=0.07, 95%CI:-0.02-0.17, p=0.140). After adjustment, emotionally reactive, anxious/depressed, withdrawn, and aggressive behavior scores remained significantly higher in 2018. Differences were largest among low-income families (CBCL total: adjusted mean difference=5.94, p=0.001; internalizing=2.63, p<0.001), with virtually no difference in the highest income tercile.

CONCLUSIONS: Effect sizes were small overall, yet higher scores in the 2018 cohort were concentrated in lower-income families, suggesting socioeconomic patterning of behavioral and emotional problems across cohorts.

PMID:42496908 | DOI:10.47626/1516-4446-2026-4981